Safeguards do little to control euthanasia in Belgium.

This article was published on March 27 by OneNewsNow.

Alex Schadenberg

Promised safeguards and controls for euthanasia and doctor assisted-suicide in Belgium apparently aren't working, according to the latest study.

In 2007, a study was conducted in Belgium, and figures released in the most recent examination of the practice from 2013 show it is problematic. Alex Schadenberg of the Euthanasia Prevention Coalition tells OneNewsNow experts researched over 3,700 deaths.

“And in that data they learned that 4.6 percent of all the deaths were euthanasia, which is significant and huge,” he explains. “On top of that, they found that 1.7 percent of all deaths were what they call 'hastened deaths without request.'”

In other words, doctors or nurses decided to kill an ailing person who had not requested euthanasia.

According to Schadenberg, the absence of estimates on unreported cases is glaringly apparent. He says the practice is so out of control that even people suffering depression are assisted to die.

“So the fact is that there is a serious problem, and the Belgium government needs to stop it,” he tells OneNewsNow. “The problem with euthanasia right off the bat is once you allow someone else to cause your death, once you allow in law that someone else can kill you, the one question remaining is for what reason? And when they are promoting this to people they always say, Oh, but we will have safeguards.”

But Schadenberg says the regulations are neither safe nor do they guard against abuse. He says that's also true in states in America where assisted suicide has been legalized.

• Almost half of all Belgian euthanasia deaths may not have been reported.
• New study: Euthanasia represents 4.6% of all deaths in Flanders Belgium in 2013, deaths without patient request continue.
• More than 1000 deaths may have been hastened  without explicit request in 2013 in Belgium.

Feeding Tubes and Futility in Texas.

We Can End the End-of-Life Impasse in the Texas Legislature.

Dr Jacqueline Harvey

By Jacqueline C. Harvey, Ph.D . 

After five consecutive sessions of bitter battles over end-of-life bills, the Texas Legislature is finally poised to pass the first reform to the Texas Advance Directives Act (TADA) in twelve years. An issue that created uncanny adversaries out of natural allies and equally odd bedfellows has finally found common ground in H.B. 3074: an act that simply prohibits doctor-imposed euthanasia by starvation and dehydration. Since H.B. 3074 includes only those provisions and language that all major organizations are on record as having deemed acceptable in previous legislative sessions, there is finally hope of ending the end-of-life impasse in the Texas Capitol.

Many people are surprised to learn that Texas law allows physicians to forcibly remove a feeding tube against the will of the patient and their family. In fact, there is a greater legal penalty for failing to feed or water an animal than for a hospital to deny a human being food and water through a tube. This is because there is no penalty whatsoever for a healthcare provider who wishes to deny artificially administered nutrition and hydration (ANH). According to Texas Health and Safety Code, “every living dumb creature” is legally entitled to access to suitable food and water. Denying an animal food and water, such as a case this January in San Antonio, is punishable by civil fines up to $10,000 and criminal penalties up to two years in jail per offense. Yet Texas law allows health care providers to forcibly deny food and water from human beings - what they would not be able to legally do to their pet cat. And healthcare providers are immune from civil and criminal penalties deny of food and water to human beings as long as they follow the current statutory process which is sorely lacking in safeguards. Therefore while it is surprising that Texas is the only state law that explicitly mentions food and water delivered artificially for the purpose of completely permitting its forced denial (six other states mention ANH explicitly for the opposite purpose, to limit or prohibit its refusal), it is not at all surprising that the issue of protecting a patient’s right to food and water is perhaps the one point of consensus across all major stakeholders.

H.B. 3074 is the first TADA reform bill to include only this provision that is agreed upon across all major players in previous legislative sessions. Texas Alliance for Life and Texas Right to Life have each previously sponsored broad and ambitious bills to either preserve but reform the current law (Texas Alliance for Life’s position) or overturn it altogether as Texas Right to Life aims to do. Prior to H.B. 3074, bills filed by major advocacy organizations have often included ANH, but also a host of other provisions that were so contentious and unacceptable to other organizations each bill ultimately died, and this mutually-agreed-upon and vital reform always died along with it. The 2011 and 2013 sessions present a prime example where both organizations filed complicated, contentious opposing bills, both of which would have protected a patient’s right to food and water but each bill also included provisions that other groups saw as contrary to their goals. Both bills were ultimately defeated and neither group was able to achieve protections for patients at risk of forced starvation and dehydration- a mutual goal that could have been met through a third, narrow bill like H.B. 3074. H.B. 3074 focuses on what unites the organizations involved rather than what divides them.

H.B. 3074 is progress that is pre-negotiated and pre-approved. It is not a fertile springboard for negotiations on an area of mutual agreement. Rather it is the culmination of years of previous negotiations on bill that all came too late, either due to the complex nature of rival bills, the controversy involved or even both. On the contrary, H.B. 3074 is not just simple and an area of agreement, moreover, it is has already been negotiated. since Texas Alliance for Life and Texas Right to Life (along with their allies) were able to agree on language in 2007 with C.S.S.B. 439. 

The language from C.S.S.B. 439 is strikingly similar to H.B. 3074 which states, “except that artificially administered nutrition and hydration must be provided unless, based on reasonable medical judgment, providing artificially administered nutrition and hydration would: 

1. hasten the patient's death; 
2. seriously exacerbate other major medical problems not outweighed by the benefit of the provision of the treatment; 
3. result in substantial irremediable physical pain, suffering, or discomfort not outweighed by the benefit of the provision of the treatment; 
4. be medically ineffective; or 
5. be contrary to the patient's clearly stated desire not to receive artificially administered nutrition or hydration.” 

Doctor Death Nightmare

Published on March 24.

By Deborah Rankin

Margaret Somerville

A law professor at McGill University says that a recent decision of the Supreme Court of Canada overturning the ban on assisted-suicide and euthanasia is a "nightmare" and "full of errors". Margaret Somerville, the Founding Director of the Centre for Medicine, Ethics and Law at McGill made these remarks recently to a rapt audience at a public forum organized by the Newman Centre for Catholic students and faculty.

She said that the SCC decision goes farther than simply striking down the ban against aiding someone to commit suicide, permitting euthanasia by physicians in certain circumstances, while cautioning that the ruling is unclear in this regard.

In physician assisted-suicide the doctor prescribes drugs that the patient takes, whereas in euthanasia the doctor administers a lethal injection - in either scenario, ostensibly at the patient's request. However, in jurisdictions where assisted-suicide has been legalized, there are multiple examples of abuse with people being euthanized without their consent.

This is especially true in the case of children and incompetent adults who can't give informed-consent: for example, the Groningen Protocol of the Netherlands permits so-called "voluntary euthanasia" of babies at the parents' request. Pro-euthanasia advocates refer to this gruesome practice as "post-birth abortion" while opponents say that it is really a form of "closet eugenics" - if the child is born with congenital defects the parents can request euthanasia on the pretext of preventing the child from suffering.

The Atlantic - Pushing Killing for Organs

This article was published on Wesley Smith's blog on March 24, 2015.

Wesley Smith

By Wesley Smith

I have repeatedly warned about articles published in medical and bioethics journals advocating killing the profoundly disabled or dying for their organs. 

The assault on the “dead donor rule” has now filtered down to the popular media. The Atlantic has an article advocating that dying patients be killed for their organs rather than having to actually, you know, die first. From, “As They Lay Dying:” 

A more useful ethical standard could involve the idea of “imminent death.” Once a person with a terminal disease reaches a point when only extraordinary measures will delay death; when use (or continued use) of these measures is incompatible with what he considers a reasonable quality of life; and when he therefore decides to stop aggressive care, knowing that this will, in relatively short order, mean the end of his life, we might say that death is “imminent.”  

If medical guidelines could be revised to let people facing imminent death donate vital organs under general anesthesia, we could provide patients and families a middle ground—a way of avoiding futile medical care, while also honoring life by preventing the deaths of other critically ill people.  

Moreover, healthy people could incorporate this imminent-death standard into advance directives for their end-of-life care. They could determine the conditions under which they would want care withdrawn, and whether they were willing to have it withdrawn in an operating room, under anesthesia, with subsequent removal of their organs. 

There’s a name for that: Homicide. Doctors should never be killers, even for a “beneficial” purpose.

More than 40% of Belgian euthanasia deaths were not reported in 2013.

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

The New England Journal of Medicine (NEJM) published  a new study concerning the Belgium euthanasia experience titled: Recent Trends in Euthanasia and Other End-of-Life Practices in Belgium.

Similar to previous studies, researchers sent a questionnaire to 6188 physicians who had certified death certificates in the first six months of 2013 in Flanders. There were 3751 returned questionnaires representing a 60.6% response rate. The data represents about 6% of all deaths in 2013.

The data in the study indicates that:

1. 4.6% of all deaths were euthanasia. There were 61,621 total death in 2013.
2. .05% of all deaths were assisted suicide.
3. 76.8% of the requests for euthanasia or assisted suicide were granted.
4. 1.7% of all deaths were hastened without explicit request.

With help from a Belgian researcher I learned that in 2013 there were 61,621 total deaths in Flanders Belgium. Since the data from the study indicated that 4.6% of all deaths were euthanasia, therefore there were approximately 2834 assisted deaths in Flanders in 2013.

The data did not include information concerning the number of unreported euthanasia deaths.

Since the official Belgian euthanasia report states that there were 1807 reported assisted deaths in Belgium, of which, 1454 were in the Flanders region, therefore approximately 1380 assisted deaths were not reported in Flanders Belgium in 2013.

Last year, Dr Marc Cosyns, a Belgian euthanasia doctor, admitted that he does not report his euthanasia deaths.

This means that more than 40% of all euthanasia deaths were not reported in Flanders in 2013.

The study also found that 1.7% of all deaths were hastened without explicit request. Since there were 61,621 deaths in Flanders, therefore approximately 1047 deaths may have been hastened without explicit request in Flanders Belgium in 2013.

The recent Supreme Court of Canada assisted death decision suggested that abuse of euthanasia laws in other jurisdictions was only anecdotal. Canada needs a Royal Commission to set the record straight. 

Euthanasia is out-of-control in Belgium.

To learn more about the abuse and extension of euthanasia in the Netherlands and Belgium purchase my book: Exposing Vulnerable People to Euthanasia and Assisted Suicide.

• New study: Euthanasia represents 4.6% of all deaths in Flanders Belgium in 2013, deaths without patient request continue.
• More than 1000 deaths may have been hastened  without explicit request in 2013 in Belgium.
• Belgium euthanasia deaths increase by 26% in 2013.
• Belgian doctor admits to not reporting euthansia deaths.
• Belgian euthanasia promoter admits to problems with the euthanasia law.

Chilean girl who asked for euthanasia, changes her mind.

Alex Schadenberg
Euthanasia Prevention Coalition

Valentina Maureira

A 14-year-old Chilean girl, who asked the Chilean President, to allow her to die by euthanasia, has now changed her mind and wants to live.

Valentina Maureira, who lives with Cystic Fibrosis, created a youtube video last month asking the Chilean President, Michelle Bachelet, to allow her to die by euthanasia. Valentina got the idea from the Brittany Maynard assisted suicide campaign.

On February 28 President Bachelet met with Valentina. Presidential spokesman Alvaro Elizalde stated that 'it's impossible not to be overcome by emotion with the girl's request, it's impossible to grant her wish,' because it's not allowed under Chilean law.

Valentina has changed her mind after meeting with a family from Argentina.

Maribel Oviedo

Valentina's father said that his daughter was moved by a visit from a Argentina family, whose children also have Cystic Fibrosis.

He said Valentina was given hope by meeting someone who had survived beyond age 20 with the disease.

Maribel Oviedo and her father Ernesto traveled to Santiago to 'convey a message of hope.'

Maribel, 22, watched her sister Marisol die of cystic fibrosis in 2013. Mirabel received a lung transplant in 2012 and told Valentina that she now lives a normal life.

Mirabel offered to go to a doctor's appointment with her because she wanted to encourage her to live.

Valentina's story is emotionally charged. If Valentina had died by euthanasia, her options, potential treatment and opportunity to change her mind would have ended.

Now Valentina has hope.

Belgian doctor justifies euthanasia for depressed people.

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

Godelieva De Troyer died by euthanasia in 2012.

An interview with Wim Distelmans, the chairman for the federal euthanasia commission in Belgium, was published in HLN.BE   (google translated) on March 15. where Distelmans explains that there were 50 - 60 psychiatric patients who died by euthanasia in 2013 - 2014. Distelmans states:

"It is a small group, 50 to 60 patients. But it is not a negligible number:. 2 to 3 percent of the 1,924 people who were euthanized last year."

Distelmans then states:

"usually they are not old, but they suffer long. They do not belong in this world, they think.."

Distelmans promotes euthanasia for depressed people. He states (google translated):

"Manic-depressive patients are in their manic moments capable of the most improbable things, They spend their bank loot, for weeks at a five-star lodge, buy several cars one day. At that stage they are not competent. But in moments of depression they by their exhaustion come back to the baseline and are indeed competent. Then they can for instance say, "I live for thirty years crazy highs and lows, I've tried everything to break that infernal cycle Now that I'm back on the baseline, and I know that I have a couple of weeks left, back I for a dip in the depth or a jump in height. " These are people who are eligible for euthanasia."

Once euthanasia has become an acceptable solution to human suffering the only question that remains is what conditions will death become the solution for life.

Lethal injections for people with psychiatric conditions is based on a false compassion. Distelmans appears to be reacting to his fear of living with chronic depression.

• Depressed woman dies by euthanasia in Belgium.
• Court challenge: Belgian doctor kills depressed patient by euthanasia.
• A second complaint against Belgian euthanasia doctor.

New Euthanasia Bill in Tasmania

This article was published on the HOPE Australia website on March 20.

Paul Russell and
Alex Schadenberg
in Tasmania.

By Paul Russell, the director of HOPE Australia.

The Tasmanian MPs who tabled and pushed the last Euthanasia bill defeated in 2013, have said that they will try again later this year.

The then Premier, Lara Giddings MP and her then deputy, Nick McKim MP, now on the opposition benches made the announcement in The Examiner Newspaper on the 14th of March.

But bringing the issue to a vote in this new bill will not be as easy as it was when the then Premier and her Deputy were in control of the parliamentary debate from the treasury benches.

Moreover, whereas the vote in 2013 was resolved by 13 votes to 11, a cursory look at the chamber post the 2014 election suggests that the numbers are at least at that level if not more strongly against.

When Giddings and McKim had the privilege of office behind them, a faux discussion paper arising out of the Premier's Office and full control of the timing of the debate, they still could not find a majority on the chamber.

It is always possible that votes change and we must ever be vigilant, but I cannot help but observe that this seems more like grandstanding than it does about anything else.

• Euthanasia bill defeated in Tasmania.
• Nitschke: Frank admissions on Tasmanian radio.

More than 1000 Belgian deaths were hastened without explicit request in 2013.

By Alex Schadenberg

Alex Schdenberg

Executive Director Euthanasia Prevention Coalition.

Contrary to the Supreme Court decision that struck down Canada's laws that protect people from assisted death, in Belgium, where euthanasia has been legal since 2002, a significant number people are dying by euthanasia without request.

Yesterday I wrote an article about the study published in the NEJM on March 19, 2015 on the experience with euthanasia in Flanders Belgium.  The study sent 6188 questionnaires to the physician who certified death certificates in the first half of 2013. The researchers received 3751 responses representing a 60.6% rate of return. The data indicated that 4.6% of all deaths were euthanasia and .05% of all deaths were assisted suicide.

This study found that 1.7% of deaths in the Flanders region of Belgium, in 2013, were intentionally hastened without explicit request. A similar study in 2007 found that 1.8% of deaths in the Flanders region of Belgium were hastened without explicit request, meaning that the problem continues.

Since there are 61,621 deaths in Flanders in 2013 and since the study found that 1.7% of all deaths were hastened without explicit request, therefore more than 1000 deaths were hastened without explicit request in 2013 in Flanders.

The Supreme Court of Canada assisted dying decision stated that abuse of euthanasia laws are anecdotal. A previous Belgian study in 2007 found that 1.8% of all deaths were hastened without explicit consent and this new Belgian study (2013) found that 1.7% of all deaths were hastened without explicit consent representing no statistical change in Belgium.

The Associated Press article interviewed Belgian ethicist Freddy Mortier. The article stated:

Mortier was not happy, however, that the 'hastening of death without explicit request from patients,' which can happen when a patient slumbers into unconsciousness or has lost the capacity for rational judgment, stood at 1.7 percent of cases in 2013. In the Netherlands, that figure was 0.2 percent.

People need to recognize that euthanasia or assisted suicide laws will be abused. Will assisted death be your choice or will it be imposed on you?

To learn about the abuse and expansion of euthanasia in the Netherlands and Belgium order my book: Exposing Vulnerable People to Euthanasia and Assisted Suicide.

• New study: Euthanasia represents 4.6% of all deaths in Flanders Belgium in 2013, deaths without patient request continue.
• Supreme Court of Canada decision is irresponsible and dangerous.
• Belgium euthanasia deaths increase by 26.8% in 2013.
• Belgian euthanasia promoter admits to problems with the euthanasia law.

Study: Euthanasia represents 4.6% of all deaths in Flanders Belgium in 2013, deaths without patient request continues

By Alex Schadenberg

Executive Director and International Chair - Euthanasia Prevention Coalition

The New England Journal of Medicine (NEJM) (March 19, 2015) published the basic statistics related to a new study titled: Recent Trends in Euthanasia and Other End-of-Life Practices in Belgium.

Similar to previous studies, this study 6188 questionnaires to physicians in Flanders Belgium in the first half of 2013. The study received a 60.6% response rate by receiving 3751 returned questionnaires.

The data indicates that:

1. The percentage of euthanasia deaths increased from 1.9% of all deaths in 2007 to 4.6% of all deaths in 2013 representing a 242% increase in 6 years. 

2. The percentage of assisted suicide deaths decreased from .07% of all deaths in 2007 to .05% of all deaths in 2013 representing no statistical difference. 

3. The percentage of requests for euthanasia or assisted suicide increased from 3.5% of all deaths in 2007 to 6.0% of all deaths in 2013. 

4. The percentage of requests for euthanasia or assisted suicide that were granted increased from 56.3% in 2007 to 76.8% in 2013.

A significant and continuous problem in Belgium is the number of hastened deaths without explicit request from the patient.

In 2007, 1.8% of all deaths were hastened deaths without explicit request while in 2013, 1.7% of all deaths were hastened deaths without explicit request.

Since there were 61,621 deaths in 2013 in Flanders Belgium and since 1.7% of all deaths are hastened without explicit request, therefore approximately 1047 deaths are hastened each year without request in Flanders Belgium.

Further research needs to be done concerning these deaths without explicit request. In 2007, approximately 1 in 3 hastened deaths without explicit request were euthanasia.

The study also indicates that the use of continuous deep sedation until death decreased from 14.5% of all deaths in 2007 to 12% of all deaths in 2013. It is possible that the increase in euthanasia deaths accounts for much of the decrease in deaths by continuous deep sedation.

Continuous deep sedation until death is known as "slow euthanasia" when the physician sedates a patient, who is not otherwise dying and withdraws water and food to cause death by dehydration.

The issue of continuous deep sedation has become very important now that France is debating a bill to widen the application of continuous deep sedation.

• Belgium euthanasia deaths increase by 26.8% in 2013.
• Belgian euthanasia promoter admits to problems with the euthanasia law.
• Montero: Euthanasia in Belgium has expanded considerably.
• Depressed woman dies by euthanasia in Belgium.
• Woman with anorexia nervosa dies by euthanasia in Belgium.

Organ donation, euthanasia and assisted suicide.

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Several days ago I received a phone call from Sharon Kirkey who was writing an article concerning the practice of organ donation after assisted death, an article that was published in the National Post. Kirkey asked me my thoughts on whether organ donation would occur after assisted death? It is interesting that she didn't include any of my quotes in the article. I said:

Sharon, you are asking the wrong question. Any person who signs their organ donor card and who dies by assisted death would be eligible for organ donation.

I then said to her:

The real question is whether or not, in the future, organ donation and assisted death will be coupled.

There was some silence on the other end of the phone. I continued.

If a person has signed their organ donor card and if they have been approved for assisted death, why wouldn't the organs be donated? Once assisted death becomes more common, why wouldn't they remove the organs before lethal injection? Death by lethal injection and death by removal of vital organs is the same thing, simply done in a different way.

Sharon questioned me further and I said:

My concern is that in the future euthanasia will be sold to the public as "good for society."

By coupling organ donation with assisted death, new social pressure will be created for people with healthy organs who are living with disabilities, depression or chronic conditions. They will be subtly encouraged to "voluntarily" die by "assisted death" for the "common good."

Whether I like it or not, if "assisted death" becomes legal, organ donation will soon be subtly promoted as a "good outcome" of assisted death and later become overtly promoted especially for people who are living with disabilities, depression, or chronic illnesses. The healthiest organs make for the best transplants.

John Kelly: Say 'no' to assisted-suicide expansion in Oregon

This article was published by Oregonlive on March 17.

John Kelly, is a director of the disability rights group Not Dead Yet and founded Second Thoughts.

John Kelly

Even as the Oregon-based Death with Dignity National Center and other assisted suicide proponents continue to insist that "there have been no efforts to expand either (Oregon or Washington's) law beyond their strict guidelines," here comes House Bill 3337, which would stretch the meaning of terminal illness from six months to 12 months.

Oregon became the first state to legalize assisted suicide in part by highlighting so-called "safeguards" like the requirement that people have a "terminal disease" -- the prediction by two doctors that "within reasonable medical judgment" a person would die inside six months. But even at six months, the death knell of "terminal" was arbitrary and approximate. Studies have shown that 15 to 20 percent of the supposedly "terminally ill" outlive their prognosis, leading to our current situation whereby six-month hospice programs discharge 200,000 people yearly for living too long!

The Oregon Health Authority has participated in this "terminal" charade by not disclosing how many program participants lived longer than six months, giving instead a range of survival after the initial request for prescribed suicide. Nevertheless, every report this century has included someone who lived longer than a year -- one person living almost three years after first request. Under the new proposal, it is guaranteed that innocent people would lose years of their lives under the mistaken belief they were dying when they were not.

Deep Sedation: France is in danger of buying a deadly illusion.

Dr Kevin Fitzpatrick OBE, is the director of EPC International and lives near Avignon France.

Dr Kevin Fitzpatrick

France is in danger of buying a deadly illusion: that terminal sedation is neither assisted suicide nor euthanasia. In the Netherlands it can be both, and the numbers of people being terminally sedated there are growing at an alarming rate. From the minute the Assemblée Nationale should pass any such legislation, terminal sedation will become the lie to hide the practice of euthanasia throughout France too.

On Tuesday March 17, 2015 the French parliament overwhelmingly voted to give people the right to demand terminal sedation – that is, for them to be made unconscious in their last hours and days. We have been warning about the steep rise in the use of terminal sedation in the Netherlands, as a form of ‘back-door’ euthanasia.

In the Netherlands, only informed adults who meet all the criteria of the Dutch law are counted as euthanasia deaths. None of those who are unable to give informed consent, a key element of the Dutch law, are counted. So no neonates killed because of their disabilities, no older people with dementia, or those in persistent coma, no-one who finds some doctor willing to ‘grant’ them a euthanasia death because they fail to meet Dutch legal criteria. Those who die through terminal sedation are not generally counted either, but the rise in their numbers is frightening.[1]

Even in those cases where deep sedation is a serious consideration, for those few individual people whose refractory symptoms cannot be managed by modern palliative medicine, profound questions remain to be answered. But in the 1990s this group was estimated at below 5% of all cases.[2] Today palliative care specialists, and advances in their field, mean that fewer than 2% of patients are faced with terminal sedation as their only option.[3] Of course every individual deserves our best response, but if their numbers are falling why then should terminal sedation be on the rise at all? In the Netherlands or anywhere else?

To create a specious ‘right’ to die by terminal sedation as the French propose, is yet another hoodwink – it allows a larger public to believe this is all being done so maturely, with such compassion, and manages to avoid all the thorny questions about assisted suicide and euthanasia. It does no such thing. And simply claiming that such deaths will be neither assisted suicide nor euthanasia cannot change the fact that, often, this is exactly what they are.

Administering a lethal dose in order to bring about death is killing, it is murder, and many French doctors have spoken out against the latest proposal having no wish to be drawn over to this sinister side of the debate. Administering a dose to relieve pain which may have the double effect of ‘hastening death’ is not always subtly different. The question is: who can tell? A doctor, a nurse, a pharmacist? The relevant information is usually guarded or hidden, but we may hope to be able to find out. Hidden intentions are so much more difficult to unearth. Protesting doctors know that from their own experience.

President Hollande is said to have been convinced of the need for legalised euthanasia by the death of his mother Nicole in 2009. The Claeys-Leonetti proposal that calls for terminal sedation on demand has garnered cross-party support, something the beleaguered leader needs after other failures have seen his popularity drop below that of any previous incumbent of the highest office in France. The point here is that political careers can be built or can fall on such ‘opportunities’ – this is never a clean debate.

The Dutch and the Belgians openly admit their legal frameworks were intended to ‘regularise’ already existing and illegal practice, they say ‘so as to avoid abuse’. Yet those illegals acts, so prevalent it took new legislation to accommodate them, were never prosecuted. And avoiding abuse is so far from what has happened in either country, when under-reporting remains at nearly a quarter of all euthanasia deaths in the Netherlands. Research suggests the rate of unreported deaths is even higher in Belgium. But in Belgium the leading euthanasia practitioner heads up the oversight committee, which has never referred one euthanasia death reported to it for investigation. It is easy to see why doctors might not even be bothered to report. Or why nurses are committing euthanasia, which is also illegal. [4]

The Belgians also openly admit their law was framed to support suicide for disabled people, and insist this is a matter of patient choice. The inherent discrimination against disabled people is exacerbated by entirely removing patient choice into the hands of a third party, usually a doctor. In another terrible irony, the lobby for assisted suicide/euthanasia argue that no-one should be ‘forced’ to spend their last moments unconscious. They cannot have it both ways.

In France, the debate has split Assemblée deputies – 121 of them co-signed an amendment to legalise ‘active medical assistance to die’ which would come worryingly fast – the patient’s demand for euthanasia would be confirmed over 2 days, and 3 doctors’ opinions would see the person dead in just 4 more days, with no serious controls in place apart form a mention in their medical notes.

The choice will be between "double-effect sedation" and barely disguised euthanasia. It is not cynicism that makes me say the majority of the sedation deaths will be euthanasia deaths, it is experience. I bitterly regret that part of human nature which will move so swiftly and seamlessly to the worst edges of practice – the fact is, once it ‘becomes legal’ so many who stop now, pause and ask themselves ‘Is this really right?’ will simply shrug and say instead ‘Well, it’s legal now’ – that is one of the conditions those people need to bury the last vestiges of their consciences in ‘I’m only following orders.’ Now where have we heard that before? In that other great and most destructive illusion…

1. Agnes van der Heide, et al ‘End-of-Life Practices in the Netherlands under the Euthanasia Act’ New England J Med 2007; 356:1957-1965 May 10, 2007 DOI: 10.1056/NEJMsa071143
2. Heintz, A P M (1994) 'Euthanasia can be part of good terminal care' British Medical Journal vol 308, p1656
3. From private conversation with a palliative care specialist
4. Alex Schadenberg Exposing vulnerable people to euthanasia and assisted suicide ISBN 978-1-897007-27-3 

Dr Jacqueline Harvey: Testimony to the Connecticut Public Health Committee on assisted suicide.

To the Honorable Members of the Connecticut Public Health Committee,

Dr Jacqueline Harvey

Today I urge you to oppose S.B. 668 and the harm it would bring to the people of Connecticut, especially those who are vulnerable and in greatest need of support and care. I am a bioethicist and public policy scholar with a Ph.D. in Public Administration and Policy from University of North Texas. As an American. I represent the U.S. affiliate of the Euthanasia Prevention Coalition (EPC), an international organization that was founded in Canada with affiliates in Europe, Australia and around the world. My specializations as an academic are in public health policies, particularly state-level laws that govern end-of-life decisions and I have taught policy courses in my home state of Texas and most recently, in the health policy studies program and the University of Michigan-Dearborn. My research on this particular issue has been published in many venues, most recently in The Public Discourse. This is why I can assure you from my own studies and reviews of academic literature that the legalization of active, voluntary euthanasia through assisted suicide will usher in considerable harm for your state.

In late 2012, I conducted a thorough literature review that scoured academic studies on the effects of assisted suicide (AS). The goal was to learn the consequences to states which have legalized this practice (specifically Oregon and Washington) in order to determine the actual costs and benefits with which to compare to claims by both AS proponents and opponents alike. Opponents cited fears of poor end-of-life care, elder abuse and misdiagnosis - all of which have been vindicated by research. Predictions that legal AS may lead to coaxing and coercing unwilling patients toward ending their lives by limiting or denying palliative care have been confirmed by reports of incidents where terminally ill citizens were told by state medical plan authorities that they would not pay the cost of pain-control, but would cover the cost of their suicides. While spending for palliative care has increased, one study indicated that 24 percent of patients who chose AS reported that they did not have adequate finances to cover expenditures for medical care and equipment, in spite of the fact that 98 percent of respondents had health insurance. Pressure on patients to end their lives for the benefit of others has been established in Oregon and Washington in study after study, which found patients choosing AS did not report a higher quality of death than those dying naturally, but caregivers sometimes did. Additional research also found that caregivers of patients in both Oregon and Washington who ended their lives by AS were themselves suffering from substantial financial and health-related harms, and although respondents claim that none of these factors was associated with the decision to end the patient’s life, Washington State reported in 2011 that over half of respondents choosing AS mentioned “concerns about being a burden” as a reason for choosing to take their own lives.

There is also the reality of patient misdiagnosis and the possibility of treatable depression. A review of studies also determined that physicians’ medical diagnoses were often incorrect, both in declaring a patient to have a terminal condition and estimating their life expectancy at six months or fewer. Another study of physicians who were willing to prescribe the lethal dose found that 27 percent were not confident that they could determine if a patient only had six months or fewer to live. A prognosis of only six months equals 180 days maximum, and yet Oregon’s report indicates the number of days between writing the lethal prescription and the patient’s actual death ranged from zero to 698 days (nearly two years). One report discusses a AS opponent from Oregon who was told that she had only six months to one year to live; today, over 11 years later, she is still alive. There is also substantial evidence that many patients opting to end their lives suffer from treatable depression and physicians report that patients for whom interventions were made (like treating depression) were more likely to change their minds about wanting to end their lives. One analyst, after examining Oregon’s most recent annual report found that physicians who prescribe the lethal medications are failing to refer for necessary psychiatric evaluations of patients, many of whom might reconsider suicide if properly treated. This prompts the question of how many people freely choose AS or are pressured into the decision by negative circumstances, especially circumstances for which there is some or complete relief.

Great News: Montana House passes bill to prohibit assisted suicide.

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

Montana has taken a big step forward in passing a bill that would protect Montanan's from assisted suicide.

Today the Montana House passed bill HB 477, by a 51 to 48 vote. HB 477 would include physician-assisted suicide within the current state law that prohibits "aiding or soliciting suicide."

On Friday, HB 477 had a tie vote (50 to 50). On Saturday, the bill was brought back for reconsideration and today it passed.

HB 477 will now go to the Montana Senate.

For the last few years Montana has had confusion with respect to assisted suicide. In 2009, the Baxter lower court decision stated that Montana citizens had a right to assisted suicide. Baxter was appealed to the Montana Supreme Court that decided Montana citizens do not have a right to assisted suicide. The court did not overturn the assisted suicide statute, but the court did grant a tightly worded potential defense of consent, if a physician was prosecuted for assisted suicide.

Therefore physician-assisted suicide remained illegal in Montana, since prosecution for assisted suicide remained possible.

Senate Bill 202, a bill that would have legalized assisted suicide in Montana failed to pass in the Senate Judiciary Committee.

What the Supreme Court of Canada decision on physician-assisted dying means for physicians

Statement from the Canadian Medical Protective Association (CMPA) concerning the Supreme Court - Carter assisted dying decision.

"This means that at this time it remains illegal for anyone, including physicians, to counsel, aid, or abet a person to commit suicide."

In a landmark decision, the Supreme Court of Canada unanimously declared the criminal prohibition against physician-assisted dying unconstitutional. While the February 6, 2015 decision is important, the Canadian Medical Protective Association (CMPA) wants physicians to keep in mind several important facts.

The most important is that the Court suspended the decision for 12 months to give Parliament and the provincial legislatures time to enact legislation, and medical regulatory authorities (Colleges) and medical associations time to develop policies and guidelines. This means that at this time it remains illegal for anyone, including physicians, to counsel, aid, or abet a person to commit suicide.

The Court’s decision is also limited to situations in which the patient is a competent adult person who clearly consents to the termination of life. In addition, the patient must be suffering from “…a grievous and irremediable medical condition […] that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.”¹

In an attempt to clarify what might be considered a “grievous and irremediable medical condition,” the Court stated that it includes an illness, disease, or disability. Moreover, the term “irremediable” is not intended to require the patient to attempt treatments that the patient considers unacceptable.²

The Court expressly recognized a physician’s right to refuse to assist a patient to die based on freedom of conscience. The Court deferred to Parliament, provincial legislatures, and Colleges to establish appropriate frameworks that reconcile the Charter rights of patients and physicians.

Montana House debates bill to stop assisted suicide.

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

Montana House

Montana came one step closer to closing the door on assisted suicide. on Thursday March 12, when the Montana House passed House Bill 477, by a vote of 51 to 49. HB 477 would include physician-assisted suicide within the current state law that prohibits "aiding or soliciting suicide."

(Update: The vote to send the bill to the senate was tied 50 to 50  on Friday March 13. The bill may be dead.)

For the past few years Montana has faced a confusing situation with respect to assisted suicide. In 2009, the Baxter court decision declared that Montana citizens had a right to assisted suicide. This decision was appealed to the Supreme Court in Montana that decided that Montana citizens do not have a right to assisted suicide. The Court did not overturn the statute protecting Montana citizens from assisted suicide, but the Court did grant a tightly worded defense of consent, if a physician was prosecuted for assisted suicide.

Therefore physician-assisted suicide remains illegal in Montana, if prosecuted, a physician could use a defense of consent.

According to the Revalli Republic news Rep. Jerry Bennett, the sponsor of the bill, stated that the bill faces a final vote on Friday before it can advance to the Montana Senate. Bennett stated:

Montana already has a high suicide rate, and that in Oregon, which allows assisted suicide, the suicide rate is much higher than the national average.

Senate Bill 202, a bill that would have legalized assisted suicide in Montana was defeated last month at the Senate Judiciary Committee.

Kevin Fitzpatrick: Conversation with Terry Pratchett.

Terry Pratchett, an author and a euthanasia promoter, died a natural death at the age of 66.

By Dr Kevin Fitzpatrick, the director of EPC International.

Dr Kevin Fitzpatrick

My first ‘outing’ on the assisted suicide/euthanasia debate was a student debate in Trinity College Dublin. I was very new to the subject and in truth, a very slick Phillip Nitschke wiped the floor with me. I swore it would never happen again, although something similar did, just once more, a couple of months later when the supposedly independent chair of a debate in London, Jon Snow, aggressively turned on those of us who were opposed to legalising any third party intervention in decision-making at the end of someone’s life. I have learned a great deal since then, have a much deeper understanding of the catastrophic consequences of laws permitting assisted suicide and/or euthanasia.

Another of my opponents in Trinity that evening was Sir Terry Pratchett. He asked me for a conversation afterwards, and I was happy to oblige, to try to understand his thinking and motivation better.

He struck me as an intelligent, considered, but understandably frightened man. As much as I detest what he has done to promote such terrible outcomes, I think he was genuine in his fear. He listened respectfully to me, in complete contrast to Nitschke, and we spoke for as long as possible with the queue of ardent young fans waiting for his autograph and a chance to speak to their hero. I could not deny them for very long. He was as kind to them as he had been in seeking me out in the first place.

I thought it interesting how little he seemed to be fronting the media coverage of the debate after Dublin. Though I have no insight into why, except that he won the audience hearts that night by pausing frequently to search for his words. They too reacted with natural human sympathy for a man faced with an uncertain future apart from the knowledge that death would not be far away. He did say he was finding it harder to do stints like this. Barely three and a half years later, he has died at the early age of 66, from his ‘embuggerance’, Alzheimer’s Disease.

I discovered a gentle man, concerned to listen and evaluate anew. Would that I had had the depth of knowledge I do now – at the time I had nothing to offer him that might have changed his mind. For I think he would have listened. I have no wish to be disrespectful to the man, which is more than I can say for Nitschke who, thankfully, has just been struck off by the Australian Medical Association. The contrast between an intelligent, thoughtful and deeply worried man and the other one, could not be greater. Pratchett had a warm reaction to me that led me to believe he was more in solidarity with me as a disabled man than he was with Australia’s Doctor Death.

I have said nothing since about Terry Pratchett except what I repeat here now. Some of my colleagues in opposition to legalising assisted suicide/euthanasia might find it strange, distasteful, even wrong that I should say this much about him, but on the only evidence I have, I stand by this: he was convinced by his own experience of suffering. He drew conclusions diametrically opposed to mine. But he also witnessed the death of Peter Smedley in that awful Swiss house, and so watched a man struggling to die for more than half an hour, choking to death in the most terrible way, enduring the very kind of death he had sought to avoid at all costs. How that affected the world-famous author I do not know.

Simon Stevens: Assisted suicide is just wrong.

This article was published in the Huffington Post on March 11, 2015.

By Simon Stevens, is an independent disability issues consultant.

You can call it assisted dying, assisted suicide, mercy killings, helping people along or anything else you want, but whatever you call it, I would say it is just wrong.

The debates and pressure to legalise assisting dying has focused on the right to choose how we die, but this is in reality a right afforded to no one as we live in a world where no one knows when they we are going to die.

You may argue that people who commit suicide know when they are going to but few people actually plan to commit suicide as a rational act to take control of their destiny and it is not a form of action that has gained any acceptance within society. I am sure daytime TV will never be offering advice on how to have a good suicide! Instead, suicide and suicidal thoughts come as a possible immediate solution to a period of immense depression or frustration. It is an irrational desire that comes from people not seeing other ways forward.

When a supposedly well or non-disabled person commits suicide, there is shock and horror as people examine the environmental causes that may have led them to suicide, generally concluding the real reasons may probably always be a mystery. If a non-disabled or well person expresses a desire to commit suicide, those they tell are most likely to do everything they have to talk them out of their desire by asking them to think of the positive things in their life.

When a sick or disabled person commits suicide, the rules change. There is an unspoken assumption they had a valid reason to do so with people remarking they are probably better off now. More worrying is families, coroners and the media seem eager to make clear conclusions, particularly that 'stress' caused by their interaction with DWP is a key reason for their suicide, when there could in reality be a whole range of factors. I find this politicisation of what is a tragic event quite sickening and deeply worrying, as it shows deep rooted prejudices toward sick and disabled people.

And when sick and disabled people show a desire to wish to commit suicide, assisted or unassisted, suddenly what is normally perceived as an irrational non-starter caused by depression is reframed as a brave and courage rational decision that is obviously correct given their circumstances. The person's environment, that may be the reason for their despair, is totally ignored as the focus becomes how they supposedly feel about their impairment or illness.

While I can totally understand how people can feel and their desire is clearly genuine, my concern is how those around them, as well as the media and society at large, respond differently to their desire because they are sick or disabled. There is deep rooted prejudices towards sick and disabled people that are not yet openly discussed and are allowed to be celebrated to a degree.

I strongly believe the same deep rooted prejudices that are used to justify assisted suicide are the same prejudices that are in place when the media and other complain about disabled people who are found fit for work in a manner they regard as unfair, and recently the pity for disabled people who are sanctioned in a manner they perceive as unfairly. I am further argue that many sick and disabled people can share these prejudices and they are not exempt just because of their status.

Because these prejudices are framed as compassion, fairness, justice and so on, they are extremely difficult to currently challenge, leaving those of us who see it clearly as being regarded as heretics, criticised for not being compassionate enough! But the inclusion of disabled people is never going to move forward towards something more meaningful until we expose and truly challenge the deep rooted prejudices that exists within most current social policy around sick and disabled people.

Assisted suicide and how it is being framed as an act of compassion is perhaps the crossroads to society deciding what it really thinks about sick and disabled people. If assisted suicide becomes law, it could be the start of a slow and steady 'compassionate' path to a new kind of holocaust for sick and disabled people that we will not realise is happening until it is far too late.

• Simon Stevens: Why I oppose assistd suicide.